Penetrating Injuries of the Heart and Great Vessels - Fifteen Years of Experience of the Cardiac Surgery Service as a Part of the Major Trauma Centre

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F61989592%3A15110%2F18%3A73588333" target="_blank" >RIV/61989592:15110/18:73588333 - isvavai.cz</a>

Alternative codes found

RIV/00098892:_____/18:N0000038

Result on the web

<a href="http://www.achot.cz/dwnld/achot_2018_2_144_148.pdf" target="_blank" >http://www.achot.cz/dwnld/achot_2018_2_144_148.pdf</a>

DOI - Digital Object Identifier

—

Result language

čeština

Original language name

Penetrating Injuries of the Heart and Great Vessels - Fifteen Years of Experience of the Cardiac Surgery Service as a Part of the Major Trauma Centre

Original language description

PURPOSE OF THE STUDYOutcome analysis of penetrating cardiac and great vessels injury within the 15-year existence of the cardiac surgeryservice as a part of the major trauma centre of the University Hospital OlomoucMATERIAL AND METHODSRetrospective analysis of a group of a total of 16 patients who underwent a surgery for penetrating cardiac and greatvessels injury since II/2002 to XI/2016. The dominant causes of penetrating trauma were stab injuries (15 patients, 94%),in one patient only (6%) it was a gunshot injury. The mean age of the patients included in the group was 42.9 ± 16.1 years,with men significantly prevailing (13 patients, 81%). A total of 7 injured persons (44%) were haemodynamically stable whenadmitted, 9 injured persons (56%) were unstable or in critical condition. The average transfer distance was 48.8 ± 34.5 km;the injured were admitted on average 115.9 ± 154.8 minutes after being injured. Preoperatively, all the injured suffered frompericardial effusion (&gt;5 mm) confirmed by TTE (81%) or CTA (19%). In 4 patients (25%) pericardial drainage for cardiactamponade was performed before surgery. RESULTSAll the penetrating cardiac and great vessels injuries were repaired by cardiac surgeon, in one case only (6%) theextracorporeal circulation support was used. The injury of coronary arteries was in one case managed by CABG and in theother case by ligation of the peripheral part of the coronary artery. In 4 patients (25%) also a penetrating injury of otherorgans was simultaneously managed. The mean ICU stay reached 85.8 ± 91.9 hours, on average 5.6 ± 9.3 units of redblood cells were administered during the in-hospital stay which lasted on average 7.1 ± 2.4 days. In the group a non-significant increase of left ventricular ejection fraction (44.1 ± 4.7 vs. 49.3 ± 3.2, p = 0.882) was reported at discharge ofthe injured patients. One patient died on the 78thday of hypoxic brain damage (6% three-month mortality). The long-termsurvival analysis showed 94% one-year and 88% five-year cumulative survival in the group.DISCUSSIONThe incidence of the penetrating cardiac and great vessels injury is directly dependent on the crime level in the respectivecountries and regions. A cardiac arrest, severe hemodynamic instability, unconsciousness, serious concomitant injury,gunshot injury, multiple or atrial injury represent independent predictors of death in these injuries. The total three-monthmortality in penetrating cardiac and great vessels injury ranges from 18 to 42%, the presence of vital signs at the time ofhospital admission is associated with 78–92% probability of survival. The surviving patients show excellent long-term resultswith the exception of those who suffered a severe damage to valve apparatus or with significantly depressed left ventricularfunction.CONCLUSIONS Our experience proves a high survival rate of patients with penetrating cardiac and great vessels injury. The centralisationof the care into the major trauma centre with a cardiac surgery background, a unified treatment algorithm, and a vitalinterdisciplinary cooperation are the key goal of successful management of these injuries. Penetrating Injuries of the Heart and Great Vessels-Fifteen Years of Experience of the Cardiac Surgery Service as a Part of the Major Trauma Centre | Request PDF. Available from: https://www.researchgate.net/publication/324965517_Penetrating_Injuries_of_the_Heart_and_Great_Vessels-Fifteen_Years_of_Experience_of_the_Cardiac_Surgery_Service_as_a_Part_of_the_Major_Trauma_Centre [accessed Oct 20 2018].

Czech name

Penetrating Injuries of the Heart and Great Vessels - Fifteen Years of Experience of the Cardiac Surgery Service as a Part of the Major Trauma Centre

Czech description

PURPOSE OF THE STUDYOutcome analysis of penetrating cardiac and great vessels injury within the 15-year existence of the cardiac surgeryservice as a part of the major trauma centre of the University Hospital OlomoucMATERIAL AND METHODSRetrospective analysis of a group of a total of 16 patients who underwent a surgery for penetrating cardiac and greatvessels injury since II/2002 to XI/2016. The dominant causes of penetrating trauma were stab injuries (15 patients, 94%),in one patient only (6%) it was a gunshot injury. The mean age of the patients included in the group was 42.9 ± 16.1 years,with men significantly prevailing (13 patients, 81%). A total of 7 injured persons (44%) were haemodynamically stable whenadmitted, 9 injured persons (56%) were unstable or in critical condition. The average transfer distance was 48.8 ± 34.5 km;the injured were admitted on average 115.9 ± 154.8 minutes after being injured. Preoperatively, all the injured suffered frompericardial effusion (&gt;5 mm) confirmed by TTE (81%) or CTA (19%). In 4 patients (25%) pericardial drainage for cardiactamponade was performed before surgery. RESULTSAll the penetrating cardiac and great vessels injuries were repaired by cardiac surgeon, in one case only (6%) theextracorporeal circulation support was used. The injury of coronary arteries was in one case managed by CABG and in theother case by ligation of the peripheral part of the coronary artery. In 4 patients (25%) also a penetrating injury of otherorgans was simultaneously managed. The mean ICU stay reached 85.8 ± 91.9 hours, on average 5.6 ± 9.3 units of redblood cells were administered during the in-hospital stay which lasted on average 7.1 ± 2.4 days. In the group a non-significant increase of left ventricular ejection fraction (44.1 ± 4.7 vs. 49.3 ± 3.2, p = 0.882) was reported at discharge ofthe injured patients. One patient died on the 78thday of hypoxic brain damage (6% three-month mortality). The long-termsurvival analysis showed 94% one-year and 88% five-year cumulative survival in the group.DISCUSSIONThe incidence of the penetrating cardiac and great vessels injury is directly dependent on the crime level in the respectivecountries and regions. A cardiac arrest, severe hemodynamic instability, unconsciousness, serious concomitant injury,gunshot injury, multiple or atrial injury represent independent predictors of death in these injuries. The total three-monthmortality in penetrating cardiac and great vessels injury ranges from 18 to 42%, the presence of vital signs at the time ofhospital admission is associated with 78–92% probability of survival. The surviving patients show excellent long-term resultswith the exception of those who suffered a severe damage to valve apparatus or with significantly depressed left ventricularfunction.CONCLUSIONS Our experience proves a high survival rate of patients with penetrating cardiac and great vessels injury. The centralisationof the care into the major trauma centre with a cardiac surgery background, a unified treatment algorithm, and a vitalinterdisciplinary cooperation are the key goal of successful management of these injuries. Penetrating Injuries of the Heart and Great Vessels-Fifteen Years of Experience of the Cardiac Surgery Service as a Part of the Major Trauma Centre | Request PDF. Available from: https://www.researchgate.net/publication/324965517_Penetrating_Injuries_of_the_Heart_and_Great_Vessels-Fifteen_Years_of_Experience_of_the_Cardiac_Surgery_Service_as_a_Part_of_the_Major_Trauma_Centre [accessed Oct 20 2018].

Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

—

OECD FORD branch

30201 - Cardiac and Cardiovascular systems

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2018

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Acta Chirurgiae Orthopaedicae et Traumatologiae Cechoslovaca

ISSN

0001-5415

e-ISSN

—

Volume of the periodical

85

Issue of the periodical within the volume

2

Country of publishing house

CZ - CZECH REPUBLIC

Number of pages

5

Pages from-to

144-148

UT code for WoS article

000431090500011

EID of the result in the Scopus database

—